This book tells it like it is without a great deal of concern for political correctness or the tentative guarded language that so often hides the truth about addiction, recovery, and relapse.

After 40 years of following the new research and treatment practices for addiction, Terry Gorski became frustrated at the misinformation about alcohol and other drug addictions and the narrow and incomplete approaches to treatment, recovery and relapse prevention.

In this book, Terry provides the best information on the current science-based upon an accurate understanding of what the core addiction syndrome is and what the an effective addiction treatment process needs to look like if it is to increase the chances of recovery and decrease the risk of relapse.

This book is easy to read and loaded with useful information. The book can be quickly read from beginning to end, and then kept as a handy reference to find specific information that can be used as a guide to manage the problems and crises that are so often a part of the addiction and recovery process.

The message is simple: addiction is a biopsychosocial disease. science-based understanding of what the core addiction syndrome is and what the core addiction treatment process needs to look like if it is to increase the chances of recovery and decrease the risk. Here are some of the key ideas developed in depth with the book:

Addiction is a biopsychosocial disease. Bio means biological or of the body, Psycho means psychological or of the mind, Social means the relationships that develop among people and with the social and legal systems that are needed for responsible living.

Biologically, addiction is marked by brain dysfunction that disrupts the reward chemistry of the brain creating cycles of intense euphoria and powerful craving.

Psychologically addicted people slowly adjust their ways of thinking, feeling, acting that allows them to deny and rationalize the problems caused by the it addiction.

Gradually, over time, an addictive beliefs develops that create a powerful denial system. This denial blocks the ability to recognize the addiction, interferes with the ability to ask for and accept help, and creates a deadly spiral of progressively more severe relapse episodes.

Socially, addiction pushes away sober and responsible people while attracting and feeling attracted to addicted and irresponsible people. The result is a tragedy. The addict abuses, disregards, and destroys those who love and try to help them. Active addicts set themselves up to be exploited by other addicted people and are vulnerable to predators who use and abuse them.

Most importantly Straight Talk About Addiction provides hope. Addiction and be understood, recovery is possible, and relapse can be prevented it effectively managed should it occur.

This book is easy to read and understand. It is loaded with useful information. Many people read it from beginning to end to get a comprehensive understanding of addiction, recovery, relapse, and related problems. Many people keep the book handy so they can use it as an easy-access reference to find useful information that can be used to effectively manage addiction-related problems.

The message is clear: Recovery is possible. Relapse can be prevented or effectively managed should it occur. There is hope.

Paying it forward is the giving back to posterity an equal or greater benefit than we have received in our lives.

Today I received a message that asked me why I was publishing the links to sources that support Addiction as Biopsychosocial Disease, Recovery as a development process of growth and change, and Relapse Prevention as a critical tool in the lifelong battle against a chronic relapse-prone illness.

The answer is simple. I am paying forward the great joy and benefits I was so freely given by others in my life.

There are effective research-based treatments that produce high recovery rates. It is important that we know this and that we are a able to stand our ground when people challenge our positions.

The books, articles, citations, references in text books, and new spin-off treatment approaches are all part of a knowledge-base that has taken thousands of professionals many decades to develop and organize.

Now is the time to pass this knowledge-base forward. The mantle of leadership is being transferred to a new generation. These dynamic new-era clinicians need to build upon this historical foundation, including the principles and practices that have stood the test of time and research. They need to transcend the limitations of popular yet ineffective approaches.

Our motto needs to be INCLUDE and TRANSCEND.

We need to develop a living stream of dynamic frameworks that can integrates new knowledge with the wisdom of the past at the speed if the internet. We need to set a high standards.

Our goal needs to be to relegate the problem of addiction to the trash piles of other diseases that humanity has suffered and died from, but eventually found ways to eliminate.

Knowing the history of the profession and the sequence in which treatment approaches were developed is critical to rapidly developing the knowledge and skills needed to keep the addiction profession moving forward.

The future is upon us, and like it or not, we all a part of history.

“One person can make a difference. Every person should try!” ~ John F. Kennedy

You may be that one person. Strive to leave the world a better place than you found it.

“The average American moves once every five years.” – Jared Diamond, The World Until Yesterday

This statistic has great implications for recovery and relapse. A big part of recovery involves building a network of trusted, sober, and responsible people.

After a geographical move, it takes between one and three years for most people to become comfortable in their new communities. Little things that were routine and habitual become stressful. Such simple things as finding a new doctor or dentist, finding a new cleaner, barber, or beauty shop, and simply getting in the habit of finding your way around the new community without getting lost all add additional stress. Recovering people, unless they are skillful in managing the stress of change, are at an increased risk of relapse when they move to a new community.

An even bigger problem is that the general society is focused around the use of alcohol and other drugs. The most visible recreational activities focus around bars, sports activities where alcohol is sold, and socializing with people who are likely to have someone in their family who is addicted or abusing alcohol or other drugs, especially marijuana. Even in many Church Groups, the regular and heavy use of alcohol and other drugs is more common than most of us would like to believe.

With the exception of Alcoholics Anonymous (AA) and other 12-Step Programs, most recovery resources and sobriety-based social activities are not readily visible. Even so, finding a 12-Step Group that meets individual needs and preferences, and building a trusting relationship with members of the group takes time.

Most professional services for addiction and related mental health disorders are highly stigmatized. With the centralizing of medical data it can be dangerous for career options to have a diagnosis of alcoholism, prescription drug addiction, or addiction to illicit drugs. This stigma and risk of exposure through centralized computerized medical records is one obstacle even to the office-based treatment of prescription narcotic addiction by getting Suboxone treatment from a doctor’s office.

Many “healthy” people become anxious and tend to isolate to avoid the stress of adapting to a new community and new social networks. Recovering people experience that stress in a much higher degree.

As a result, times of change puts many recovering people at a higher risk of relapse due to the lack of a well-established and comfortable recovery program, trusted relationships with sober and responsible people, the invisibility of most recovery resources and sober social opportunities, and the relative invisibility and social stigma attached to recovery-oriented treatment services.

We don’t have to fight it. We can transcend it. We can take it in, understand and learn from it. We can mix it with what we already know and move beyond the limits of our previous knowledge, point of view, or frame of reference.

We transcend something when we go beyond, rise above, cut across, or surpass some previous limit or boundary.

The word transcend comes from
Old French transcendre or Latin transcendere, from trans- ‘across’ + scandere ‘climb.’ The origin of the word therefor implies the idea of climbing or moving across something, especially a limitation or an obstacle.

Transcendence takes us beyond the limits of a previous paradigm, belief, or way of thinking. Transcendence in a spiritual sense, transcendence involves moving beyond the limits of ordinary human consciousness usually in an experiential and nonverbal way.

The idea of transcendence implies moving to a higher level or expanding to a wider and more all-encompassing frame of reference.

Transcendence usually results from an active process that unfolds in stages:

Stage 1: Identifying a personally important problem or area of new knowledge or skill. The key seems to be the initial desire or motivation that becomes harnessed in stage 2.

Stage 2: Total absorption in solving the problem, learning the skill, or figuring out how to achieve a desires state of consciousness. This involves reading, studying, discussing, and mentally wrestling with the problem.

Stage 3: Persistent Intense Effort: This process leading to transcendence is usually so intense that it leads to exhaustion and the inability to continue to hold related ideas in consciousness. This results in the person feeling a need to let go and stop trying.

Stage 4: Sudden and Unexpected Insight: The exhaustion is followed by a period of fitful rest. During this period of rest the unconscious mind or higher self integrates the previous disconnected ideas and presents the conscious mind with a spontaneous insight which is often called “The Aha” experience.

Stage 5: Documentation: The insight is often fragile and quickly forgotten unless written down or concretely expressed. In this way the idea of transcendence and creativity are similar because they both emerge from the same process.

Transcendence is an important idea in recovery from addiction, psychotherapy, spiritual development and personal growth. The process of transcendence that leads to a bigger and more useful frame of reference and a different and more useful point of view is essential to all of these processes. Most people find that as they mature they learn how to transcend or use above pain and problems in life in order to find meaning and purpose.

I believe the recovery chart depicted her is modified from the framework of the Matrix Recovery Model.

The model is developmental in nature (i.e. their are a series of developmental steps and stages of recovery). The idea of Post Acute Withdrawal is built into the model by intruding the the concept of “hitting the wall” which is a severe episode of PAW. PAW however, was not specifically mentioned in early versions of the model.

The Matrix Model was popular during the years of “The Cocaine Epidemic” in the 1980”s and 1990’s. It was an empirical model growing out of treatment experience and I clinical practice.

As with many other models it was expanded to include all addictive substances without any real evidence it was valid. It implies progressive recovery, with relapse as a treatment recovery failure.

There is no specific relapse prevention plan or emergency plan to stop relapse quickly should it occur. As a result the model, toy knowledge, has not adapted to integrate the chronic life-style related disease model and the need for relapse prevention and management of the course of the entire lifespan.

The model has been used in many programs and helped many people to recover.

I cannot locate the specific diagram and it is not referenced. The idea that neurological symptoms of recovery (PAW) can be predicted by days abstinent is controversial. Stage of addiction, type and amount of drug(s) used, age and health status of the patient, type of treatment, nutrition and stress management effect the progression of recovery.

Stephen Covey, in his book The Seven Habits of Highly Effective People identifies a group of tasks that he calls Sharpening the Saw. These type of activities involve both preparation and maintenance. They don’t need to be schedules with a precise deadline. As a result they can get put on the back burner with no immediate negative consequences. Here are three general ways of thinking that might motivate you to keep your saw sharp.

(1) The general rule is that there is never time to prepare, but there is always time to get bogged down in fixing the problems that happened because you were not prepared.

(2) There is never time to do it right, but there is always time to fix the time-consuming cascade of problems that result from doing it wrong.

(3) Maintenance can always be put off until tomorrow, right up to the point of a critical meltdown in an important area of your life. Think about life as a car. You can put off changing the oil one-day-at-a-time, but eventually the engine starts having problems and eventually breaks down.

Don’t Get Stuck In The Middle Of The River

There was a man who was a bridge-builder on a tight schedule. He built the first section of the bridge, but didn’t have time to put in all the bolts on the support beams. To save time he took his tools and materials on the first section of the bridge, did not properly secure the bolts and then move his tools and equipment onto the third section of the bridge. By this time the first section of the bridge fell down behind him and he was so busy he did not even notice it — until he needed more supplies, turned around and found himself trapped on a middle span of the bridge high in the air with nowhere to go. He was trapped be half measures and the failure to plan and maintain.

How many of you know someone who never had time to spend with their spouse, until they found themselves communicating with an attorney after their spouse filed for divorce?There are five repeating steps in the cycle of successful living: